U-Isaac O. Opole, MD, PhD, ngugqirha oqinisekisiweyo webhodi oyingcali kwiyeza ze-geriatric.Usebenze iminyaka engaphezu kwe-15 kwiYunivesithi yaseKansas Medical Centre apho naye unguprofesa.
I-Percutaneous endoscopic gastrostomy yinkqubo apho ityhubhu yokutya eguquguqukayo (ebizwa ngokuba yi-PEG tube) ifakwe ngodonga lwesisu esiswini.Izigulane ezingakwazi ukuginya ukutya ngokwazo, iibhubhu ze-PEG zivumela izondlo, ulwelo kunye namayeza ukuba ahanjiswe ngokuthe ngqo kwisisu, ukuphelisa isidingo sokudlula emlonyeni kunye ne-esophagus yokugwinya.
Iityhubhu zokutya ziluncedo kubantu abangakwaziyo ukuzondla ngenxa yesifo esibuhlungu okanye utyando kodwa banethuba elifanelekileyo lokubuyisela.Bakwanceda abantu abangenakugwinya okwethutyana okanye ngokusisigxina kodwa basebenze ngokuqhelekileyo okanye basondele kwisiqhelo.
Kule meko, ityhubhu yokutya ingaba yindlela yodwa yokubonelela ngesondlo esifunekayo kunye / okanye amayeza.Oku kubizwa ngokuba yi-enteral nutrition.
Ngaphambi kokuba ube ne-gastrostomy, umboneleli wakho wezempilo uya kufuna ukwazi ukuba unayo naziphi na iimeko zempilo ezingapheliyo (ezifana noxinzelelo lwegazi oluphezulu) okanye i-allergies kunye namayeza owathathayo.Ungadinga ukuyeka imithi ethile, efana ne-blood thinners okanye i-non-steroidal anti-inflammatory drugs (NSAIDs), de kube sekupheleni kotyando ukunciphisa umngcipheko wokuphuma kwegazi.
Awuyi kukwazi ukutya okanye ukusela iiyure ezisibhozo phambi kokuba inkqubo kunye namalungiselelo enziwe ukuba kubekho umntu oza kukulanda akugoduse.
Ukuba umntu akakwazi ukutya kwaye akanakukhetha ityhubhu yokutya, ulwelo, iikhalori, kunye nezondlo ezifunekayo ukuze umntu aphile zinokubonelelwa ngemithambo yegazi.Kaninzi, ukufumana iikhalori kunye nezondlo esiswini okanye emathunjini yeyona ndlela ilungileyo yokuba abantu bafumane izondlo ezifunwa yimizimba yabo ukuze isebenze ngokufanelekileyo, ngoko ke iityhubhu zokutya zibonelela ngezondlo ezingcono kune-IV fluids.
Ngaphambi kwenkqubo yokubeka i-PEG, uya kufumana i-intravenous sedation kunye ne-anesthesia yendawo malunga nesayithi lokusika.Unokufumana kwakhona i-antibiotics emithanjeni ukukhusela usulelo.
Umboneleli wezempilo uya kuthi emva koko abeke ityhubhu eguquguqukayo ekhupha ukukhanya ebizwa ngokuba yi-endoscope emqaleni wakho ukuze uncede ukukhokela ityhubhu yangempela ngodonga lwesisu.I-incision encinci yenziwe ukubeka i-disc ngaphakathi nangaphandle kokuvula kwisisu; oku kuvuleka kubizwa ngokuba yi-stoma.Inxalenye yombhobho ongaphandle komzimba yi-intshi ezi-6 ukuya kwezi-12 ubude.
Emva kokuhlinzwa, ugqirha wakho uya kubeka i-bandage kwi-site ye-incision.Unokufumana intlungu malunga nommandla we-incision emva kokuhlinzwa, okanye ukunyanzeliswa kunye nokungahambi kakuhle kwi-gas.Kunokubakho ukuvuza kwamanzi ajikeleze indawo yokuqhawula.Ezi ziphumo zecala kufuneka zinciphise kwiiyure ezingama-24 ukuya kwii-48. Ngokuqhelekileyo, unokususa i-bandage emva kosuku okanye ezimbini.
Ukuqhela ityhubhu yokutyisa kuthatha ixesha.Ukuba ufuna ityhubhu ngenxa yokuba awukwazi ukuginya, awuyi kukwazi ukutya nokusela ngomlomo wakho.(Kwiimeko ezinqabileyo, abantu abane-PEG tubes bangakwazi ukutya ngomlomo.) Iimveliso ezenzelwe ukutyisa ityhubhu zibonelela ngazo zonke izondlo ozifunayo.
Xa ungayisebenzisi, unokuteyipha ityhubhu esiswini sakho nge tape yonyango.Isithinteli okanye ikepusi ekupheleni kombhobho ithintela nayiphi na ifomula ukuba ingavuzi kwimpahla yakho.
Emva kokuba indawo ejikeleze ityhubhu yakho yokutyisa ipholile, uya kudibana nengcali yokutya okanye ingcali yezondlo oya kukubonisa indlela yokusebenzisa ityhubhu ye-PEG kwaye uqalise i-enteral nutrition.Nanga amanyathelo oya kuwalandela xa usebenzisa i-PEG tubes:
Kwezinye iimeko, kunokuba nzima ukufumanisa ukuba ukondla umntu ityhubhu yinto efanelekileyo yokwenza kwaye yintoni ingcamango yokuziphatha.Imizekelo yezi meko iquka:
Ukuba wena okanye othandekayo ugula kakhulu kwaye awukwazi ukutya ngomlomo, iityhubhu ze-PEG zinokunika umzimba ubushushu kunye nezondlo okwethutyana okanye ngokusisigxina ukuze uphile kwaye uphumelele.
Iibhubhu ze-PEG zingasetyenziselwa iinyanga okanye iminyaka.Ukuba kuyimfuneko, umboneleli wakho wezempilo unokususa ngokulula okanye atshintshe ityhubhu ngaphandle kokusetyenziswa kwe-sedatives okanye i-anesthetics ngokusebenzisa i-traction eqinile.Emva kokuba ityhubhu isusiwe, ukuvulwa kwesisu sakho kuvalwa ngokukhawuleza (ngoko ukuba kuvela ngengozi, kufuneka ubize umboneleli wakho wezempilo ngoko nangoko.)
Ingaba ukutya ityhubhu kuphucula umgangatho wobomi (QoL) kuxhomekeke kwisizathu sokutya ityhubhu kunye nemeko yesigulane.Uphononongo lwe-2016 lujonge izigulane ze-100 ezifumene iibhubhu zokutya.Emva kweenyanga ezintathu, izigulane kunye / okanye abakhathaleli baxoxwa nabo.
Ityhubhu iya kuba nophawu olubonisa apho kufuneka igungxulwe khona ngokuvula kudonga lwesisu.Oku kunokukunceda uqinisekise ukuba ityhubhu ikwimeko echanekileyo.
Unokuyicoca ityhubhu ye-PEG ngokugungxula amanzi afudumeleyo ngombhobho ngesirinji ngaphambi nangemva kokutyisa okanye ukufumana iyeza, kunye nokucoca iziphelo ngezisusi zokubulala iintsholongwane.
Okokuqala, zama ukugungxula ityhubhu njengesiqhelo ngaphambi nangemva kokutya.Ukuba ityhubhu ayigungxulwanga okanye ifomula yokutyisa inzima kakhulu, ukuvala kuyenzeka.Biza umboneleli wakho wezempilo ukuba ityhubhu ayinakususwa.Ungasebenzisi iingcingo okanye nantoni na ukuzama ukuvala ityhubhu.
Bhalisela incwadana yeendaba yezempilo yemihla ngemihla kwaye ufumane iingcebiso zemihla ngemihla ukukunceda uphile ubomi bakho obusempilweni.
I-American Society of Gastrointestinal Endoscopy.Funda malunga ne-percutaneous endoscopic gastrostomy (PEG).
U-Ojo O, uKeaveney E, uWang XH, uFeng P. Iimpembelelo ze-enteral tube feed kumgangatho wobomi obunxulumene nempilo kwizigulane: ukuhlaziywa okucwangcisiweyo.nutrients.2019; 11 (5) .doi: 10.3390 / nu11051046
U-Metheny NA, u-Hinyard LJ, u-Mohammed KA. Iziganeko ze-sinusitis ezinxulumene ne-trachea kunye ne-nasogastric tubes: i-NIS database.Am J Crit Care.2018; 27 (1): 24-31.doi: 10.4037 / ajcc2018978
I-Yoon EWT, i-Yoneda K, i-Nakamura S, i-Nishihara K. I-Percutaneous endoscopic gastrojejunostomy (PEG-J): uhlalutyo lwangaphambili lwe-utility yayo ekugcineni isondlo somzimba emva kokungaphumeleli kokutya kwesisu.BMJ Open Gastroenterology.2016; 3 (1):e0000098:e0000do: 10.1136/bmjgast-2016-000098
Kurien M, Andrews RE, Tattersall R, et al.Gastrostomy igcinwe kodwa ayiphuculi umgangatho wobomi bezigulane kunye nabakhathaleli.I-Clinical Gastroenterology kunye ne-Hepatology.2017 Jul; 15 (7): 1047-1054.doi: 10.1016 / j.cgh260.201010101
Ixesha lokuposa: Jun-28-2022